title: [Assessment of "Contrat de bon usage" on 4 years period: conformity to guidelines--experience of anti-TNFalpha].
abstract: OBJECTIVE
  To evaluate the evolution of anti-TNFalpha prescriptions in relation with the "contrat de bon usage" between 2004 and 2007.
  
  
  METHODS
  All the infliximab, etanercept and adalimumab prescriptions were studied over the first six month period of each year between 2004 and 2007. The indications were compared with the guidelines for therapeutic use.
  
  
  RESULTS
  One thousand one hundred and ninety nine prescriptions were analysed. The number of validated prescriptions increased each year. The percentage of "good use" infliximab prescriptions increased from 68.4% to 98.5% from 2004 to 2007. All etanercept prescriptions corresponded to the validated indication group whereas the adalimumab prescriptions fluctuated from 100% to 75%. Few indications were prescribed apart from the guidelines (sarcoidosis, acute graft versus host disease and histiocytosis).
  
  
  CONCLUSIONS
  The use of anti-TNFalpha drugs has progressed over the last 4 years, in accordance with the "contrat de bon usage". This is due to a better knowledge of these drugs, a good evolution of guidelines and the active participation of the medical team in the "contrat de bon usage" plan.
authors.affiliation: Service Pharmacie, Hôpital Saint-Louis, APHP, 1 avenue Claude Vellefaux, Paris, France. christine.plard@sls.aphp.fr
authors.forename: Christine
authors.initials: C
authors.lastname: Plard
authors.forename: Géraldine
authors.initials: G
authors.lastname: Serry
authors.forename: Pierre
authors.initials: P
authors.lastname: Faure
authors.forename: Isabelle
authors.initials: I
authors.lastname: Madelaine-Chambrin
mesh_terms: D000068879:Adalimumab; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data; D004358:Drug Therapy / Q000592:standards* / Q000639:trends; D004363:Drug Utilization; D000068800:Etanercept; D017408:Guidelines as Topic; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D000069285:Infliximab; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept